NYAPRS Note: New York State has submitted its application to the federalgovernment for approval to reinvest $10 billion in anticipated savings
from Medicaid redesign and reforms. Among the items that NYAPRS members
and friends advocated for during state webinars, regional forums and
meetings that were highlighted in the proposal include:

Phase one of the team's recommendations are estimated to save a total of
$34 billion in Medicaid funds - about half to the state and half to to
the federal government. The waiver application, touted by a slew of
health-care industry stakeholders at a Capitol news conference on
Monday, asks for $10 billion of the estimated $17.1 billion federal
savings over five years to be reinvested into New York's industry.

Cuomo assembled the Medicaid Redesign Team in January 2011 to identify
potential cost savings in the state's Medicaid program - the largest and
most expensive in the nation.

State Health Commissioner Nirav Shah demonstrated no doubt that the
federal government would provide the waiver.

"It will be approved, because all of New York state will be behind it,"
he said at the conference. "And it makes sense."

Calling the waiver "revenue-neutral," he explained approving the
application would not cost the federal government any more money. It
will, in fact, cost less money, as the feds will still realize a savings
of $7.1 billion.

Shah and Deputy Secretary for Health James Introne explained that the
$10 billion would account for start-up costs necessary to update and
modernize both the physical and organizational infrastructure of health
care in New York. That investment will generate further cost savings,
they said, assuring that the state would not be left with a
multi-billion dollar commitment when the would-be five-year waiver runs
out.

An example is a $750 million investment in supportive housing, included
as one component in the 127-page waiver application. Providing housing
and centrally located health services to the most vulnerable individuals
will save money by preventing and shortening hospitalizations, officials
said.

These individuals include patients being treated for substance abuse,
psychiatric disorders, behavioral or developmental disabilities or
chronic illnesses like HIV/AIDS. About 1 million New Yorkers fall into
the "high-cost, high-needs" category, said Harvey Rosenthal, executive
director of the New York Association of Psychiatric Rehabilitation
Services.

Ted Houghton, executive director of the Supportive Housing Network of
NY, said at the conference that 20 percent of Medicaid members account
for 80 percent of spending.

"For these people, housing is health care," Houghton said. With housing
support, "people that we really gave up on in previous generations are
becoming success stories."

Also touting both the waiver and the work of the Medicaid Redesign Team,
Paloma Hernandez, president and CEO of the Bronx-based Urban Health
Plan, Inc., said all stakeholders' opinions were considered while
developing the overhaul plan.

"When you try to improve a system," she said at the conference, "you
need to take what you do and not add to it but really transform it. And
I think that's what's being proposed here."